An interesting phenomenon is occurring in media circles these days.  No doubt others have seen it, too. Lately, doctors are being schooled by the media. From how to learn empathy, to improving communication with patients, the breadth and depth of what we should do for our patients is endless.  Why, some even have our own colleague experts tell us how we should really do things. These efforts, while probably well-intentioned, are patronizing.  ...

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Doctors, psychologists, ethicists and others, along with our society at large, debate whether "the ends justify the means." But nobody debates whether "the means justify the ends." There is no point even looking for an answer to a question that is patently silly. For now, just hold that thought, please. Medical ethics can be very challenging. There are the difficulties of interpreting "do everything" in desperate situations where heroic ...

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Injury to the brain continues to be a unique thing in medicine. These injuries are scary and unfamiliar to many health care providers. There is a finality to them. Their consequences are hidden a little bit; the asystole is easy to figure in the emergency room but the suppression and brain death isn’t something so easily recognized. They’re what you might imagine, along with polytrauma, as poster child conditions for tertiarization ...

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Most doctors have a story about being called to assist with an in-flight medical emergency. I have yet to earn one for myself, but my favorite story - passed down from resident to resident - goes something like this: An airline attendant called for a veterinarian's help. When no one answered, they settled for a doctor and an anesthesiology resident stepped up. He learned that a passenger traveling with her ...

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hipscrews Six months ago I posted a story about a demented 94-year-old patient who’d fractured her hip. She’d lost more than thirty pounds in the preceding months and had already had a collarbone fracture from a previous fall. Her son wanted her to be made comfort care only, and avoid a trip to the operating room since she was likely within six ...

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Like hand hygiene, getting workers to stay home when sick is an example of a horizontal infection prevention strategy. Horizontal strategies are multipotent (not aimed at a single pathogen), generally simple methods. While most humans inherently know that it's not a good idea to come to work with fever or diarrhea, many either can't or won't stay home and risk infecting co-workers, customers, or patients. One major reason for ...

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The ED is a hectic place. Sore throats. Heart attacks. Dog bites. Broken bones. Strokes. Major trauma. If you work in an ED, you see it all. And then some. Is it any wonder then, with the potential for literally thousands of medical and surgical problems to stumble through the doors of an ED, that hospitals and the bodies that accredit them demand strict, regimented, standard, reproducible emergency assessments and the ...

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Sexual health, though fundamentally important to every human being, is rarely discussed between patients and their healthcare providers. It’s an important conversation and one that requires doctors and patients to venture into less-than-comfortable territory. Who exactly should treat sexual health issues? Many assume that this should be the territory of a gynecologist for women or a urologist for men. But because we see our patients more frequently than any other doctors, general ...

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It’s painful enough to lose a patient. But I found it even more painful to try to console a family whom I’d never met. Depending on your point of view, the limited patient contact afforded the anesthesiologist is a disappointment or a perk of the specialty. Anesthesiologists are steadily branching out into other areas of perioperative care where lengthier patient/family contact is necessitated but the preop encounter with the anesthesiologist is ...

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Mind-Map This, apparently, is a map of my mind.  It’s a little shocking to find out that my mind looks like a sea creature, a bug, or perhaps a vegetable.  Actually, “Rob’s mind” and “vegetable” are often used in the same sentence. Someone suggested to me that I may benefit from mind mapping.  I don’t know how to describe it, but I think spatially; ...

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